Cardiovascular disease risk prevention services by pharmacists in Saudi Arabia: what do policymakers and opinion leaders think?

Abstract

Background Cardiovascular disease (CVD) is an emerging contributor to national morbidity and mortality in Saudi Arabia. CVD risk prevention services are limited, particularly with an over-utilised public health sector and an under-utilised and under-resourced primary care sector. Globally, there is evidence that community pharmacists can play a key role in CVD prevention within primary care. However, the perspectives of policymakers and opinion leaders are critical to successful translation of evidence into practice. Thus, the aim was to engage policymakers and professional leaders in discussions about implementing high-quality CVD risk prevention services in community pharmacy. Methods Qualitative semi-structured interviews were conducted, audio-recorded and transcribed verbatim. All transcripts were thematically analysed. Results A total of 23 participants (87% male) from government and non-government sectors were interviewed. Of these, almost 65% had pharmacy qualifications. Limited provision of CVD risks preventative services in primary care was acknowledged by most participants and building community pharmacists’ capacity to assist in preventive health services was viewed favourably as one way of improving the status quo. The data yielded four key themes: (1) future pharmacy CVD health service models; (2) demonstrable outcomes; (3) professional engagement and advocacy; and (4) implementability. CVD health services roles (health screening, primary and secondary prevention services), pragmatic factors and tiered models of care (minimal, medium, and comprehensive pharmacist involvement) were discussed. The need for humanistic, clinical, and cost effectiveness outcomes to be demonstrated and active involvement of professional bodies were deemed important for such services to be sustainable. Professional pharmacy governance to develop pharmacy careers and workforce, pharmacy curricular reform and ongoing education were posed as key success factors for novel pharmacy roles. Practice policies, standards, and guidelines were seen as required to adhere to stringent quality control for future pharmacy services provision. Participant’s implementation vision for such services included scalability, affordability, access, adoption and health system reform. Most discussions focused on the need for structural improvement with limited input regarding processes or outcomes required to establish such models. Conclusions Most participants favoured pharmacy-based CVD risk prevention services, despite the variability in proposed service models. However, prior to developing such services, support structures at the health system and health professional level are needed as well as building public support and acceptability for pharmacy services.

Prevalence, hematological parameters, and coagulation profiles

“…4 In Saudi Arabia, NCDs overall account for approximately 73% of all mortality and CVD in particular is the main cause of death, accounting for approximately 37% of all NCD deaths. 5,6 Ischemic heart disease (IHD) and stroke are among the top 10 causes of death in the Middle East, with IHD ranking second and stroke ranking fourth in Saudi Arabia. 7 Several risk factors contribute to the development of CVD, a few of which are hypertension (HTN), diabetes mellitus (DM), hypercholesterolemia (HyCh), cigarette smoking, and obesity.…”

Multicenter Cross-Sectional Study on Perceptions and Roles of Community Pharmacists in the Prevention and Management of Cardiovascular Disorders in Northwest Ethiopia

“…This was correlated and supported by different studies. [26][27][28][29] Promoting healthy behaviours of the general public is a key population strategy for reducing its burden and this may also be the driving point to CPPs for actively engaging to deliver cardiovascular disease prevention and treatment.…”

Comparing knowledge, attitudes, and practices in cardiovascular disease prevention and health promotion between community and hospital pharmacists in Saudi Arabia: A cross-sectional study

“…One possible solution to address this is to upgrade the capability of pharmacists to provide CVD preventive care. Above all, policymakers are in favor of empowering pharmacists to provide CVD preventive services and health promotion ( Almansour et al, 2021 ). This study provides a valuable insight into community and hospital pharmacists' knowledge, attitude and practice regarding CVD prevention.…”

“…Pharmacists shall be actively involved in many programs, including monitoring CVD risk factors, optimizing medications, diseases and health care wellness, public health, educational consultations, and preventive care ( Alshahrani et al, 2020 , Newman et al, 2020 , Vigneshwaran et al, 2013 ). Much research has established pharmacists' involvement in preventing and controlling CVD ( Alavudeen et al, 2023 , Almansour et al, 2021 , Fahs et al, 2018 , Peletidi et al, 2019 ). A recent report confirmed that practicing community pharmacists in Saudi Arabia have considerable knowledge and understanding of CVD risk factors ( Sulaiteen et al, 2023 ).…”